[Ip-health] MSF: The XDR-TB Emergency Will Require New Strategies and New Tools

[Sheila.SHETTLE@geneva.msf.org]

The XDR-TB Emergency Will Require New Strategies and New Tools:=0D
                     Business as Usual Would be Fatal=0D
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   New MSF analysis shows greater investment required to make TB history=0D
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Paris/Geneva, 30 October 2006 =E2=80=93 Relying on the standard World Healt=
h=0D
Organization (WHO) TB strategies in the face of extensively drug resistant=
=0D
tuberculosis (XDR TB) will be fatal, the international medical humanitarian=
=0D
organisation M=C3=A9decins Sans Fronti=C3=A8res (MSF) warned today.  To res=
pond to=0D
the XDR-TB outbreak, WHO will need to get newer drugs to patients as soon=
=0D
as possible by ensuring accelerated development of new drugs already in=0D
clinical trials.  Existing TB drugs and diagnostics are not adequate to=0D
combat the disease, and a new analysis being released by MSF as the 37th=0D
Union World Conference on Lung Health begins this week in Paris shows that=
=0D
none of the TB drugs currently in development, however promising, will be=
=0D
able to drastically improve TB treatment in the near future.  WHO must take=
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the lead in ensuring there is major reprioritisation and increased funding=
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of TB research.=0D
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With 450,000 new cases of drug resistant TB globally each year, resistance=
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to drugs is a problem that is growing at a rapid pace.  People with XDR-TB=
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are resistant to both of the first-line antibiotics used to treat TB as=0D
well as to two classes of second-line drugs, making treatment with existing=
=0D
drugs virtually impossible.  XDR-TB is particularly alarming in the context=
=0D
of HIV, as people who are co-infected with HIV/AIDS could die before test=
=0D
results can confirm their drug resistance. Using standard drugs to treat=0D
XDR-TB without knowing whether there is drug resistance could effectively=
=0D
condemn a patient to death.  MSF doctors have been struggling to treat TB=
=0D
with the tools available today, a matter which is exacerbated by the HIV=0D
pandemic.=0D
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=E2=80=9CBusiness as usual would be a disaster when it comes to treating XD=
R-TB,=E2=80=9D=0D
said Dr. Fran=C3=A7oise Louis, MSF TB and HIV/AIDS advisor. =E2=80=9CXDR-TB=
 has the=0D
potential to be devastating in places where HIV/AIDS is widespread. But=0D
trying to treat XDR-TB with the tools we have today would be like trying to=
=0D
put out a forest fire with a garden hose.=E2=80=9D=0D
=0D
To respond to the XDR-TB outbreak, WHO will need to get newer drugs to=0D
patients as soon as possible by working with regulatory agencies and=0D
pharmaceutical companies to ensure fast-track clinical development and=0D
availability of new drugs for =E2=80=9Ccompassionate use.=E2=80=9D  The org=
anization will=0D
also need to push to accelerate the development of more easy-to-use tests.=
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This will require WHO to take a lead and not simply delegate responsibility=
=0D
to product development partnerships.=0D
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The emergence of XDR-TB is a reflection of how the WHO approach to TB has=
=0D
failed, particularly by neglecting research and development into urgently=
=0D
needed new drugs and diagnostics that could help reduce the nearly two=0D
million TB deaths each year.  The drugs in today=E2=80=99s standard TB trea=
tment=0D
were developed in the 1950s and 1960s and the most commonly used TB test=0D
was developed over a century ago and manages to detect TB in only about=0D
half of the cases.  In addition, existing TB drugs and tests are even less=
=0D
adapted for use in people who also have HIV/AIDS.=0D
=0D
=E2=80=9CThe XDR-TB outbreaks in southern Africa should sound the alarm for=
 what=E2=80=99s=0D
going on with TB on a larger scale,=E2=80=9D said Dr. Tido von Schoen-Anger=
er,=0D
director of MSF=E2=80=99s Campaign for Access to Essential Medicines.  =E2=
=80=9CWe=E2=80=99re still=0D
simply not seeing the necessary urgency and major investment into research=
=0D
and development that is needed to make sure the basic science of TB gets=0D
translated into newer drugs that can shorten and improve treatment, and=0D
diagnostic tests that can be used in resource-poor settings.=E2=80=9D=0D
                                    ###=0D
MSF treats 17,000 patients with TB in over 94 projects in 44 countries and=
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is seeing an increasing number of cases of multi-drug resistant TB (MDR-TB)=
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.  Some patients in MSF projects diagnosed with MDR-TB in the former Soviet=
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Union have XDR-TB.=0D
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For full report: http://www.accessmed-msf.org/documents/TBPipeline.pdf=0D
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+++++++++++++++++++++=0D
Sheila Shettle=0D
Communications Officer=0D
M=C3=A9decins Sans Fronti=C3=A8res=0D
Campaign for Access to Essential Medicines=0D
Rue de Lausanne 78=0D
1211 Geneva=0D
Switzerland=0D
+ 41.22.849.8403=0D
sheila.shettle@geneva.msf.org=0D
www.accessmed-msf.org=0D
=0D